Hepatic superscan on [

purposeThis systematic review examines hepatic superscan on [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) imaging, investigating its clinical and prognostic implications.

methodsPubMed, Web of Science, and Scopus databases were used to conduct a systematic search and were updated until March 4, 2024. A visual scoring system (VSS-HS) was developed by the authors for molecular imaging feature analysis. Survival analysis was performed via Kaplan‒Meier curves, log-rank tests, and Cox proportional hazard analyses, with p values < 0.05 indicating statistical significance.

resultsThe review identified 38 eligible studies with 40 patients from the PubMed, Scopus, and Web of Science databases. Etiologic factors included hematologic malignancies, infections, fulminant metastases, metabolic disorders, drug-induced hepatotoxicity, multiple neoplasia, and hepatic neoplasm. The clinical manifestations vary, with 70% presenting with fatigue and 57% presenting with acute liver failure signs. Most patients exhibited intense hepatic hypermetabolism (VSS-HS3, n = 28). Sixteen patients died during a median 29-day follow-up, with a 1-year overall survival of 42.3%. Fatalities are most common in patients with hematologic malignancies and fulminant metastases. Drug-induced hepatotoxicity and fulminant metastases have high etiology-specific mortality rates, exceeding 62%. Univariate analysis revealed that VSS-HS and etiologic factors significantly influenced overall survival (p < 0.04 each) with the latter remained significant in multivariate analysis (p = 0.001).

conclusionHepatic superscan is a unique molecular imaging pattern, and further investigation is needed to understand its clinical implications and prognostic value.